April 9, 2024 • 30 mins
Hussein Hassanali, Associate Dentist at Woodthorpe Dental Centre is joined by Dr Ritesh Aggarwal, Dentist and CEO at Psynergy Mental health to talk about the wellbeing of your associate dentists and share their advice on keeping them happy and engaged.
What you’ll hear:
- Getting associates more involved with the wider team
- Creating a sense of belonging and open culture
- Utilising skills and strengths
- Dealing with micromanaging
- Clinical autonomy
- Associates investing in themselves.
Who should listen:
- Practice managers
- Practice owners
- Associate dentists.
Hussein graduated from the University of Liverpool in 2009 and completed his PG Dip in Restorative Dentistry in 2020 which granted Fellowship of BAARID. He is an Associate Dentist in York with a special interest in ultrasonic restorative dentistry. He has a broad range of experience, having worked in both NHS and private, and both corporate and independent practices. To date, he has over 20 publications to his name, and continues to support the profession through his regular contributions, as well as being on the BDJ Reader Panel and an Editorial Advisory Board Member of Young Dentist Magazine.
Dr. Ritesh Aggarwal is a practicing Dentist, Practice Principal and the CEO of Psynergy Mental Health. He has been working within the mental health industry since 2017 and has a strong drive and determination to improve mental health for all. Ritesh wants to improve the dental industry by implementing Psynergy programmes via their digital platform to measure the mental health and wellbeing culture of dental practices, creating action plans for improvement and inspiring positive, long term behaviour change for the benefit of all with the practice. Psynergy is currently trying to shift the paradigm of mental health to a more preventative approach, similar to dentistry, and is working closely with NHS research teams to achieve this. To find out more visit https://www.psynergymentalhealth.com/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to BODCAST, the Business of Dentistry podcast, brought to you by Practice Plan.
BODCAST delivers the best business advice, real-life stories,
and practical hints and tips to make your practice a more profitable and sustainable business.
And now, here's your host. Oh, hello again, everyone.
We are back with Practice Plan, and I'd like to thank Practice Plan for having
(00:23):
me, well, do another one of these podcasts.
I almost said webinar because because I can see people, but you won't be able to.
So the podcast is, and today what I'd like to do is I'd like to welcome Ritesh
Agarwal, more fondly known to everyone as Rick.
So Rick, I know you've done some podcasts with Praxis Fan before and you've
done some work with them, but if you'd like to give us a quick introduction
about yourself to start with.
(00:44):
Yeah, sure. Hi, Hussein. Yeah, my
name's Rick. I am a practice owner and a practicing dentist in Sheffield.
I also am the CEO of Synergy mental health.
I've done quite a lot of work with Practice Plan around the mental health and
well-being topics for them and workshops, et cetera, for dental practices.
(01:04):
As at Synergy, we are a company that is dedicated to improving the mental health
and well-being culture of dental teams.
So that's what we do. So yeah, great to be here.
Brilliant. Well, today's topic that we'd like to pick up on is we're going to
sort of start with associates, really, and associate dentists,
because, you know, with practices growing in size,
(01:27):
businesses growing bigger and bigger, and then independent practices now becoming
groups and then groups becoming corporates, we're essentially moving on to, you know,
a sort of bigger kind of, you know, proportion of dentists being associates
as opposed to practice owners themselves.
Ourselves so I think it's good that sort of we talk about this and how it is
(01:48):
kind of you know being an associate within kind of that dynamic and for myself
personally I worked as you know an associate in independent practices in small
group practices and in corporate practices as well,
and so I think I've seen it kind of from all sides
and how it works and I think the main sort
of thing as an associate I think the first thing I'd sort of like to bring up
(02:11):
and Rick can kind of add into this is really when you are an associate you're
either a sole trader or you are sort of limited company and you are a business
within a business so how do you sort of find that rick in terms of you know
having associates being their own business within your business essentially.
It's exactly right that's exactly what you are and i've got
(02:33):
no problems with it at all you've got to you are a
self-employed member of the team you've got
to look after your own stuff your
your family all those things that come with with the
challenges of being employed or self-employed i think
uh you know associates being a
business within a business is a very good thing for dental practice and
(02:55):
dental practice owners because they are going to look after their their
business primarily but also it's in their best interest to
also look at the wider business and look after with a wider business because
that wider business is what helps them promote their business so the whole business
within a business situation is is is a good thing i think personally as long
as the associate is is happy and healthy and engaged within their roles,
(03:22):
I think that's an important word is an association being engaged,
actually, because again,
I've had colleagues who I suppose have been disengaged and they kind of just
see themselves as an individual and they're not really interested in kind of,
you know, doing more within the wider role of the practice. They kind of just
want to keep themselves to themselves.
And, you know, what's your kind of perception of that?
(03:45):
That you know is it you know do you want to kind of
try and engage these individuals into actually kind of like taking
on the role or is it you know do you just think right you know that's who
they are i just want to leave you know i just want to leave themselves kind of
you know to get on with it type thing i i
personally i would not want an
associate coming into my practice who just
(04:07):
thinks that they are there to just come and do the job
and go home it's not for me it's not the culture try
breed in in in my business and like
you hussein are a business within a business i
am my business i am the business of edge dental i think
i want people who want
to come to work who want to be engaged with all
(04:28):
team members not just dentists sticking with dentists and that kind of stuff
i think i think it's massively important because team dynamics is probably the
single single biggest factor in producing good quality work and being productive for the business.
So I think it's massively important for the associate to be,
(04:51):
like I said before, happy, healthy, and engaged at work.
When you talk about engagement, what kind of engagements are you looking for from your associates?
Are you looking for just sort of engagement clinically, just to make sure their
diaries are running well?
And, you know, trying to make sure that, you know, meeting kind of,
you know, I don't want to say financial targets because I think that's not the way for it.
(05:13):
Or are you looking for them to kind of actually offer some sort of non-clinical
engagements or, you know, audits, kind of paperwork, anything else outside the practice maybe?
Be yeah everything you know you
you mentioned before that the associates is a business within a business
so if you look at an associate business it's not just
coming in to treat patients and go home you are running
your own business and that does include financial financial
(05:36):
targets as well because you are a business you're not charity yeah and
when i talk about being engaged look it's
proven that to improve mental health and well-being within individuals creating
in things like a sense of purpose and belonging and that
kind of social interaction between team members i'm
still talking within the workplace here not necessarily outside although i'm sure.
We'll come on and talk to that talk about that but having that sense
(05:59):
of belonging is massively important you
you know i'm all for individuals expressing
their individuality but i'm even more so
all for having that happen within a full collective work
well-being workplace setting you know so we are
all engaged with each other that's really
fundamentally important you know it's in
(06:22):
the best interest of the associates to treat staff members in
the best way possible so that because they want
to get the best out of out of their support staff yeah
the dental nurses the reception team the administration team otherwise again
your business as an associate doesn't run as efficiently as it can do yeah so
having an associate that comes in that actually integrates as part of the team.
(06:44):
For me is a number one factor personality is a number one factor for sure.
Like I said, that sense of belonging as well, that all filters right the way through.
Of course, associates that keep on top of their paperwork, do their referrals
on time, make my job and the management side of things a lot easier to do,
(07:04):
is always welcomed for sure.
I've worked with some associates who are not always the most efficient at doing
their referrals, for instance, and they've had to be given a few reminders on that.
I've worked with some associates who get on and just get on and do everything
extremely efficiently.
But i think first and foremost
having the mindset of the associate to be part of
(07:26):
the practice team and that sense
of belonging that's really important to me yeah i
do agree on that because everybody's got their own individual characters and
personalities and everybody's different to that extent and everybody's got strengths
and weaknesses so i suppose you know you have to kind of try and find where
people fit in what strengths and weaknesses actually are and then in working
(07:49):
to kind of, you know, use people's strengths.
I know this was in a previous podcast, something that, you know,
talks about other people that sort of have hosted is to do with all about kind
of personality traits and what your strongest personality traits are.
And then kind of working more towards those and using them. And I guess it's
all about effective workforce utilisation to make sure that everybody's kind
(08:13):
of, you know, working with their strengths, because some of you will probably
be able to do something better than I can.
And I think that's, you know, that's good in that respect.
I suppose something else that, you know, is interesting to mention is that,
you know, as associates, we all have contracts, which is a necessary part of
the business agreement.
Although, you know, still being self-employed in business women business
(08:33):
how you know can associates kind of be kept to that self-employed status without
being treated as employees despite that contract i don't think i'm the person
to answer that you're saying i think that's an hmrc person to be honest with you and it's.
(08:54):
I've got my own ideas behind it but you know you do get some practice owners
that that, you know, they do want to micromanage a bit more,
and they do want to kind of be more controlling, I think.
And they see that as part of how they want to run their business.
And because it's their business, you can understand that they want to do it that way.
But I guess what I found from a personal point of view is sometimes because
(09:16):
they want to do it that way, that just hasn't fitted with how,
you know, the way that I like to work.
And actually, all that's left me is kind of, you know, becoming more disengaged,
I guess, away from the business.
Business so so on that note though so just just
following that through how was that approach then
so you know number one i used
(09:37):
to be an incredible micromanager actually i used
to be every little detail of my business i used
to sweat and i still do i still sweat it but
i don't put as much importance on it i'm shifting massively away from that culture
and that's a growth within me that's happened over the last few years but that
example you've just given if so what what happened how did you go about those
(09:59):
discussions let's say for instance you become more and more more and more disengaged like you said.
What did you do to try and rectify that situation? Well, for me,
I, you know, I decided that those weren't the environments I wanted to be in.
And then I kind of, you know, moved away and there were a lot of different factors behind it.
And part of them were, you know, the clinical kind of environment I was working
(10:22):
in, I suppose, kind of like the NHS be private.
So I changed, you know, I changed my situation to kind of, you know,
go and do more private dentistry, which then kind of kept me happier. And that was it.
But i've kind of also been in practice where somebody's kind
of going to you know you can do that quicker you can show
you five minutes off that appointment time things like that and you
(10:44):
know all it did was that just kind of irritated me
because i kind of thought to myself and then the words of that you know
somebody gave me once is you know you know almost
to say well if you feel you can treat that patient more efficiently why
don't you do it then which is kind of a whole putting it
but i totally respect
(11:05):
the fact that you left that environment because i would
never ever once say to
a clinician we promote clinical
freedom yeah so part of that
and one of the biggest things to promote culture is giving
people autonomy okay well if i'm going
to give you autonomy i can't then go and say oh but
(11:26):
by the way can you get that do done in 25 minutes
or whatever it might be because you know you're booking 35 minutes or
you're booking 45 minutes and you know we've got a whole economy to
scale that we've got to deal with here well that's back
to treating people as a number and not treating people as a people as a person
you know i would never shave
timings off my timings because first and
(11:46):
foremost i want to do the best work i can possibly do on every given day i'm
going into and on some days my work will be better than other days that that's
that's part of being a human being but i need a specific amount of time to do
that and if i don't have that time that creates a massive part of stress and anxiety within me.
Because i don't like keeping people waiting it's part of my customer
(12:07):
service whether i was nhs or private i've always been
in that way that's my mindset that's the way i like to treat people
so i don't believe in
in my managing in that way
i believe in having open and honest discussions though so i
believe in someone saying okay let's say for instance
they said well you know you're booking this length of time off but this
(12:29):
is a sort of cost analysis that's happening here so is the
reason why we need that length of time and you have a two-way discussion
about it to come to a situation so then you understand
the perspective of the principal and the principal understands your perspective
and between the two of you you've come to a solution that will then benefit
both of you because it's in the interest of the principal to keep their associates
(12:49):
happy and it's in the interest of the associate to be happy at work and keep
the principal happy so you've got a really good dynamic relationship.
I suppose that's the principle. You want to keep people happy because one of
the biggest growths towards a practice and towards your business is keeping
long-standing associates because that's what patients are essentially coming
(13:09):
back for. They're not coming back for the practice.
They're coming back for that dentist a lot of the time.
That's there, whether that's principal or associate often. I think also the
patients do, they come back for a plethora of reasons,
but certainly, you know, the team, you know, the wider team for sure,
(13:30):
you know, have a huge impact on the patient's experience,
obviously locality and neighbourhoods and all those things.
You know i took over a private practice
from a chap who was retiring and had
been at the practice for 30 years it was a
tough gig and i was expecting that i'm going to probably lose quite a few patients
to begin with well or and so naturally you start make provisions for that and
(13:54):
you you create all these scenarios in your head actually as it happens we probably
lost less than two percent of the patients and all those factors and all those
things that i've that in my head,
none of them materialized because we, you know, we over,
we make things more catastrophic to what they are.
Don't we, you know, in our, in our heads sort of thing. Yeah.
But yeah, no, you're right. People are coming back for the dentist and the way
(14:16):
they're treating and all those things, you know.
So it's very important that then that person is, again, happy and healthy and
engaged at work because you're not going to retain patients if you're not,
especially on a private basis.
No. And, you know, you talked about the autonomy behind it as well.
And that's really important because, again, you know, patients,
(14:39):
if they're coming back for a dentist who work in a particular way, and
I'm going to you know make a fine example of myself here because
I do everything you know
differently you know my composite's all injection molded my
crown preps are different I do a lot of work with ultrasonics actually for cavities
and things like that or the nurse you know and some of the nurses or you know
(15:00):
especially trainees or when I first started you know there are you know nurses
that qualified here for you know over a decade plus and never worked anywhere
else they They're kind of looking at me sort of scratching their heads going,
what the hell is he doing?
But that is kind of the way that I work. And I've invested a lot of money in,
you know, the equipment that I've got.
(15:20):
And, you know, they're kind of seen that I've been here nearly three years,
three and a half years, I suppose.
Sorry, two and a half years, rather. But they've seen that, you know,
there's the reason why I do things, because it does produce good clinical results.
I mean, hopefully touch wood, I've got a fairly low failure rate,
which I pride myself on, but I pride myself on delivering the best standard
(15:42):
of care that I can, because if somebody's going to be working in my mouth or
my parents' mouth or my family member's mouth,
I'm thinking to myself, no, that's what I should be aiming to deliver to everybody else.
I should not be compromising my standards ever, no matter who it is.
You know just because I think well actually you know I don't know them they're just a patient
(16:03):
they're not sort of somebody I know or somebody who's my family everybody sort
of isn't equal and everybody you know is treated you know to
the exact same kind of like clinical standard and I'd put a huge amount
of sort of my emphasis on my clinical standard and probably
to the extent that you know I certainly haven't passed the syndrome but
that's an inherent trait and I'm definitely a perfectionist
as well but that is kind of what produces my
(16:25):
result I've kind
of like lost track i'm not trying i've thought a little bit now but yeah
with the self-employed thing i mean i've said that i buy a lot
of my own equipment you know you find
that you've got associates that do this is this quite a rare thing
that you know associates are investing a lot in
themselves we've got we've got a fantastic associate at our place who is constantly
(16:48):
investing in himself and i love that and by the way i love everything that you've
just said about treating your patients like family the members that's the exact
ethos that that we have in our practice bringing in new techniques.
Helps to keep staff members engaged within
the profession as well it's not just the same oh let's churn
out a do amalgam on the nhf or
(17:09):
whatever it might be the you know staff members
get enthused nurses and and the
auxiliary staff get infused when they're learning new techniques
it's it it's it brightens up their
day so what you're doing is actually in my
opinion a principal's dream it's fantastic i've got
a fantastic associate who invests in himself goes on multiple courses
(17:31):
he buys equipment on certain equipment that he needs he'll come to me and he'll
explain to me why he needs it and i'll say yeah no problems i'll buy that for
you because i can understand why you're going to need it because ultimately
from a business case perspective is you know if If I invest in my associates and keep them happy,
they are a massive asset to me as a business.
(17:51):
Not only just the financial turnover, but also growing the reputation of the
business, the goodwill when it comes for me to sell the business on,
I'm going to benefit from that.
So I would massively encourage all associates out there to do what you've done
and try and better themselves and principals, by the way.
I learned a lot by talking just to my associates and my hygiene therapist,
(18:15):
actually, about certain techniques that they're using.
And again, hygiene therapy is another really important point to touch upon,
a massively, generally underutilized part of our profession,
also self-employed more often than not.
Again, that's even a harder position, I would say, to defend from a self-employed
perspective. So that's also a very, you know.
(18:39):
Interesting point from the hmrc point of view etc we're a massively underutilized
member of the team as well and the amounts that we can all learn from each other is just huge.
So as an associate you know when you talk about.
You know you're one of your associates come to
and say yep you know what happy to get that for you i've been
in corporates where the corporates you know basically put my business argument
(19:01):
across towards it because they're kind of like that's more the hat
that they want and they've kind of gone yep you know what see
your point let's get get it for you and then I've
been in other practices which have kind of gone no you know we
can't you know we can't justify it because
we need everybody using the same to keep it down to economies of
scale that kind of thing so if there's
something in particular that I really want something that I prefer to have how
(19:24):
do I then as an associate kind of you know have that conversation say
look you know what this is what I feel I need
to do my job better or more efficiently you know are
you willing to entertain kind of a conversation and
see where i'm coming from instead of just kind of having the owner's point
of view and kind of like going a bit you know you know because all you're seeing
is the power signs again it's a
(19:46):
tough one and you've almost answered the question yourself in terms of
you've given the business case to why you're doing it and what you're doing
and having you know i talk a lot about
authenticity particularly within leadership okay
you know and and i talk about psychological safety quite
a lot well psychological safety is being able to voice your opinions or carry
(20:06):
out certain things and tasks without fear of reprise and that's ultimately what
we're trying to build in every workplace not just dentistry okay so but you
cannot have psychological safety without having open and honest conversations.
And you can put your business case across and that's all you are in control
of agreed the the principles they're going to put their business case across,
(20:29):
and that's all they're particularly in control of.
Okay? And if at some point those two ideas or ethoses don't meet,
despite the number of honest conversations you're going to have,
then I think it's a question of, well, how valued do you feel as an associate
working for that principle?
And how valued are you as an associate to that principle?
(20:52):
Do you know what I mean? And then there's some bigger conversations to have.
Have or there's a parting of the ways yeah and they're and they're always i
tend to i tend to break things down as much as i can into what are potential outcomes and,
what can possibly happen and once i know all that i can build back up from that
situation you know what i mean but one thing i will always do i will always
(21:17):
have an honest conversation i'll explain my point of view i will listen to your point of view,
And if we, more often than not, in virtually 99% of cases, we'll come to compromises.
And that's what's after. Most people in most workplaces just want to be heard.
They want to be heard and they want to be understood.
(21:38):
And they also want to understand decision-making processes that occur,
as opposed to just, I want this, nah, computer says no.
Yeah. I think sort of being heard and sort of being understood are sort of important
things. And I mean, you know, for both associates and all team members,
I think it's important to actually understand, you know, the side from the business
(21:58):
in terms of why you would or you wouldn't do something.
And I think that's no matter what it is, whether it's new equipment or,
you know, a new system that's implemented or, you know, HMRC,
you know, infection control policy, whatever.
Because then if you understand, you know, you're actually just more likely to
do it rather than kind of, you know, being barked at.
(22:20):
I think, I suppose, one of the last things I think I probably want to mention
then, because we've covered kind of, you know, how autonomy is important,
letting associates kind of develop and kind of just be themselves within the practice.
But from an associate's point of view, I think you have to be,
you know, not just a leader, because you kind of have to still be a leader in
(22:40):
terms of bringing sort of other people in the team along with you in terms of
how you do things, why you want to do things.
And, you know, the day-to-day kind of like, you know, ways that people work,
because you still have a small team around you, even though you're,
you know, you're not actually the actual business owner itself.
But then at the same time, because you're not the, you know,
(23:03):
the owner of the practice, you're still a follower.
So you're kind of wearing two hats and, you know, you're,
How do you balance those things? Is there a good middle ground?
Is it just dependent on the day-to-day dynamics?
Because obviously that's going to change each time. Is it dependent on practice?
And I don't even know if I'm making sense with this point. I feel like I am.
(23:25):
I think you get me because you're nodding your head.
I sort of get you, 100%, because obviously, as a principle, we have that exact same dynamic.
Last, everyone thinks that the principle is completely in control.
And yes, I can understand why that's the case.
But actually, if you think about what the principal also has to deal with,
(23:47):
you know, the stress of running the business, the stress of compliance,
the stress of keeping team members happy and the dynamics of all that,
the financial aspects of it all, managing the entire practice,
not just managing, you know, your own business as well as you as Hussein Dental.
You know what I mean? so a lot of
people in dentistry and this is a good thing and
(24:09):
a bad thing i think a lot of people in dentistry wear a lot of hats and
and therefore it's constantly juggling balls
spinning plates whatever it is that we might
call it and it's very difficult i think i think
i've already touched on a few things i think having open honest
and respectful conversations is massively important okay because
(24:29):
again wearing the same hats and
being able to to voice your opinion but
also being able to respect other people's opinion and listen
and actively listen is massively important
to see other people's perspective and having a growth mindset essentially okay
i think that's really important i think looking after yourself as an associate
knowing the stress and the stressful environment the dentistry is and what you've
(24:54):
just outlined there as well is very stressful You have a responsibility to yourself
to make sure you are healthy,
you know. So looking after yourself.
Practicing techniques and self-care techniques that are going to allow you to
stay mentally healthy and more productive at work.
Okay. For the benefit of you and for the benefits of the practice,
(25:14):
you know, embracing and acknowledging stress and, and, and accepting that stress
is a part of people's lives.
And actually stress is massively important to us all. It's important for us
to have stress because that builds, that helps us build from it.
It helps us build resilience it helps us to overcome challenges
in the future so having stress is good having too
(25:37):
much stress which then becomes a feeling of overwhelm and
becomes too overwhelming is when it starts to become mentally unhealthy and
recognizing that i like using the word pressure and then
if there's too much pressure it's pressure then becomes stress so
i'm happy to have pressure because pressure once drives you but
i think when it becomes stress that's when it's just gone too far
in the wrong direction and that's when you know the pressures kind
(25:59):
of overwhelmed you and i think oh that's a good description of
it yeah listen whichever whichever description resonates
in your mind you know the world health organization talk about
stressors as the thing within their definition of mental health it you know
there's no right or wrong whatever resonates with you if you want to call it
pressures stress whatever it might be that's going to resonate the note the
(26:22):
court part is though is recognizing when those pressures or or that stress,
or those stressors are becoming too much.
And then you have to then look at things and reevaluate and try to then manage that situation.
You know, you mentioned before things like imposter syndrome,
dentistry, massive with imposter syndrome.
(26:44):
We're very isolated. Although you're an associate in a practice,
you are isolated in your surgery.
By the same token, when I practice, I'm isolated in my surgery.
So it's an isolated perfectionism you mentioned before huge
huge problem in dentistry we agonized over the
one percent that you know you might have an air blow in your composite you
won't talk about the beautiful shading that you've done and the way you've got
(27:06):
it polished and all happens you talk about this one air blow that just sticks
in your mind managing things like that are massively massively important within
our profession you know yeah and we're quite fortunate that as part of thought
you know what there's 12 of us of the dentists,
I think it's at least 12 anyway, it keeps growing.
You know, we have regular peer reviews and we do tend to kind of at least talk
(27:29):
and we've got WhatsApp chats and we're fortunate that everybody within our practice
seems to have different special interests. We've got lots of people that we can lean on.
And I think that sort of does make for a good sort of practice dynamic,
knowing that there is a lot of support out there.
And support is a big thing because clinical clinical support is,
you know, necessary in kind of today's modern kind of practising environment.
(27:53):
And you do need people that you can lean on,
But if you're kind of within a smaller practice, you know, can you kind of still
kind of get that in a smaller practice compared to such a large practice where
you've got more people around you?
Well, we're a very small practice and we're one surgery. So whenever I work,
(28:13):
I'm by myself. Whenever my associate works, they're by themselves.
As a one surgery practice, it's difficult having and not just clinical support.
You mentioned support there, but having support in general is
massively important so the biggest and the
biggest most influential thing that i have ran in
my dental practice is definitely utilizing the
(28:35):
platform from synergy mental health to understand our
workplace culture and have people comment on
what's happening within our business completely from
an entire collective perspective perspective and then
was all coming together to help us
improve the environment that's what we do
(28:55):
and that is probably been the biggest most
influential thing in my business that i've had after practicing
dentistry for two decades to be honest with you because it's brought
together a real sense of togetherness and we've
had some very challenging conversations but through
challenging conversations and working through them actually strengthens
team dynamics and team and team team
(29:17):
bonding so that's that's a
massively massively important thing and i think that you know
people should be business owners should
be doing this at all times for sure no some
great tips there rick thanks very much because yeah it's you
know it's hard being an associate and i completely say it's
hard being a practice owner and i think you know yeah it's.
(29:38):
Important that the two do meet in the middle and everybody sort
of gets on because if you don't the only person actually
suffering and fit is the patients and we're
all here for patients and that's also my room we
are and just on that note though if we don't
meet in the middle and people don't meet people actually the
people within the team and you and me we all
(30:00):
suffer and the patients as well but we all suffer and
so it's massively massively important to build
those team dynamics for sure yeah i think that's a
good final point in terms of the sort of associate dynamics i
I guess hopefully we'll be able to cover sort of the wider team dynamics later
on at some point another time so yeah thanks very much Rick for yeah taking
(30:21):
the time to join us and talking us all through some of what we need to help
our associates but also what associates can do to kind of you know help out
sort of practice owners and practice managers thanks very much again.
Music.
Welcome to BODCAST, the Business of Dentistry podcast, brought to you by Practice Plan.
BODCAST delivers the best business advice, real-life stories,
and practical hints and tips to make your practice a more profitable and sustainable business.
And now, here's your host. Oh, hello again, everyone.
We are back with Practice Plan, and I'd like to thank Practice Plan for having
(00:23):
me, well, do another one of these podcasts.
I almost said webinar because because I can see people, but you won't be able to.
So the podcast is, and today what I'd like to do is I'd like to welcome Ritesh
Agarwal, more fondly known to everyone as Rick.
So Rick, I know you've done some podcasts with Praxis Fan before and you've
done some work with them, but if you'd like to give us a quick introduction
about yourself to start with.
(00:44):
Yeah, sure. Hi, Hussein. Yeah, my
name's Rick. I am a practice owner and a practicing dentist in Sheffield.
I also am the CEO of Synergy mental health.
I've done quite a lot of work with Practice Plan around the mental health and
well-being topics for them and workshops, et cetera, for dental practices.
(01:04):
As at Synergy, we are a company that is dedicated to improving the mental health
and well-being culture of dental teams.
So that's what we do. So yeah, great to be here.
Brilliant. Well, today's topic that we'd like to pick up on is we're going to
sort of start with associates, really, and associate dentists,
because, you know, with practices growing in size,
(01:27):
businesses growing bigger and bigger, and then independent practices now becoming
groups and then groups becoming corporates, we're essentially moving on to, you know,
a sort of bigger kind of, you know, proportion of dentists being associates
as opposed to practice owners themselves.
Ourselves so I think it's good that sort of we talk about this and how it is
(01:48):
kind of you know being an associate within kind of that dynamic and for myself
personally I worked as you know an associate in independent practices in small
group practices and in corporate practices as well,
and so I think I've seen it kind of from all sides
and how it works and I think the main sort
of thing as an associate I think the first thing I'd sort of like to bring up
(02:11):
and Rick can kind of add into this is really when you are an associate you're
either a sole trader or you are sort of limited company and you are a business
within a business so how do you sort of find that rick in terms of you know
having associates being their own business within your business essentially.
It's exactly right that's exactly what you are and i've got
(02:33):
no problems with it at all you've got to you are a
self-employed member of the team you've got
to look after your own stuff your
your family all those things that come with with the
challenges of being employed or self-employed i think
uh you know associates being a
business within a business is a very good thing for dental practice and
(02:55):
dental practice owners because they are going to look after their their
business primarily but also it's in their best interest to
also look at the wider business and look after with a wider business because
that wider business is what helps them promote their business so the whole business
within a business situation is is is a good thing i think personally as long
as the associate is is happy and healthy and engaged within their roles,
(03:22):
I think that's an important word is an association being engaged,
actually, because again,
I've had colleagues who I suppose have been disengaged and they kind of just
see themselves as an individual and they're not really interested in kind of,
you know, doing more within the wider role of the practice. They kind of just
want to keep themselves to themselves.
And, you know, what's your kind of perception of that?
(03:45):
That you know is it you know do you want to kind of
try and engage these individuals into actually kind of like taking
on the role or is it you know do you just think right you know that's who
they are i just want to leave you know i just want to leave themselves kind of
you know to get on with it type thing i i
personally i would not want an
associate coming into my practice who just
(04:07):
thinks that they are there to just come and do the job
and go home it's not for me it's not the culture try
breed in in in my business and like
you hussein are a business within a business i
am my business i am the business of edge dental i think
i want people who want
to come to work who want to be engaged with all
(04:28):
team members not just dentists sticking with dentists and that kind of stuff
i think i think it's massively important because team dynamics is probably the
single single biggest factor in producing good quality work and being productive for the business.
So I think it's massively important for the associate to be,
(04:51):
like I said before, happy, healthy, and engaged at work.
When you talk about engagement, what kind of engagements are you looking for from your associates?
Are you looking for just sort of engagement clinically, just to make sure their
diaries are running well?
And, you know, trying to make sure that, you know, meeting kind of,
you know, I don't want to say financial targets because I think that's not the way for it.
(05:13):
Or are you looking for them to kind of actually offer some sort of non-clinical
engagements or, you know, audits, kind of paperwork, anything else outside the practice maybe?
Be yeah everything you know you
you mentioned before that the associates is a business within a business
so if you look at an associate business it's not just
coming in to treat patients and go home you are running
your own business and that does include financial financial
(05:36):
targets as well because you are a business you're not charity yeah and
when i talk about being engaged look it's
proven that to improve mental health and well-being within individuals creating
in things like a sense of purpose and belonging and that
kind of social interaction between team members i'm
still talking within the workplace here not necessarily outside although i'm sure.
We'll come on and talk to that talk about that but having that sense
(05:59):
of belonging is massively important you
you know i'm all for individuals expressing
their individuality but i'm even more so
all for having that happen within a full collective work
well-being workplace setting you know so we are
all engaged with each other that's really
fundamentally important you know it's in
(06:22):
the best interest of the associates to treat staff members in
the best way possible so that because they want
to get the best out of out of their support staff yeah
the dental nurses the reception team the administration team otherwise again
your business as an associate doesn't run as efficiently as it can do yeah so
having an associate that comes in that actually integrates as part of the team.
(06:44):
For me is a number one factor personality is a number one factor for sure.
Like I said, that sense of belonging as well, that all filters right the way through.
Of course, associates that keep on top of their paperwork, do their referrals
on time, make my job and the management side of things a lot easier to do,
(07:04):
is always welcomed for sure.
I've worked with some associates who are not always the most efficient at doing
their referrals, for instance, and they've had to be given a few reminders on that.
I've worked with some associates who get on and just get on and do everything
extremely efficiently.
But i think first and foremost
having the mindset of the associate to be part of
(07:26):
the practice team and that sense
of belonging that's really important to me yeah i
do agree on that because everybody's got their own individual characters and
personalities and everybody's different to that extent and everybody's got strengths
and weaknesses so i suppose you know you have to kind of try and find where
people fit in what strengths and weaknesses actually are and then in working
(07:49):
to kind of, you know, use people's strengths.
I know this was in a previous podcast, something that, you know,
talks about other people that sort of have hosted is to do with all about kind
of personality traits and what your strongest personality traits are.
And then kind of working more towards those and using them. And I guess it's
all about effective workforce utilisation to make sure that everybody's kind
(08:13):
of, you know, working with their strengths, because some of you will probably
be able to do something better than I can.
And I think that's, you know, that's good in that respect.
I suppose something else that, you know, is interesting to mention is that,
you know, as associates, we all have contracts, which is a necessary part of
the business agreement.
Although, you know, still being self-employed in business women business
(08:33):
how you know can associates kind of be kept to that self-employed status without
being treated as employees despite that contract i don't think i'm the person
to answer that you're saying i think that's an hmrc person to be honest with you and it's.
(08:54):
I've got my own ideas behind it but you know you do get some practice owners
that that, you know, they do want to micromanage a bit more,
and they do want to kind of be more controlling, I think.
And they see that as part of how they want to run their business.
And because it's their business, you can understand that they want to do it that way.
But I guess what I found from a personal point of view is sometimes because
(09:16):
they want to do it that way, that just hasn't fitted with how,
you know, the way that I like to work.
And actually, all that's left me is kind of, you know, becoming more disengaged,
I guess, away from the business.
Business so so on that note though so just just
following that through how was that approach then
so you know number one i used
(09:37):
to be an incredible micromanager actually i used
to be every little detail of my business i used
to sweat and i still do i still sweat it but
i don't put as much importance on it i'm shifting massively away from that culture
and that's a growth within me that's happened over the last few years but that
example you've just given if so what what happened how did you go about those
(09:59):
discussions let's say for instance you become more and more more and more disengaged like you said.
What did you do to try and rectify that situation? Well, for me,
I, you know, I decided that those weren't the environments I wanted to be in.
And then I kind of, you know, moved away and there were a lot of different factors behind it.
And part of them were, you know, the clinical kind of environment I was working
(10:22):
in, I suppose, kind of like the NHS be private.
So I changed, you know, I changed my situation to kind of, you know,
go and do more private dentistry, which then kind of kept me happier. And that was it.
But i've kind of also been in practice where somebody's kind
of going to you know you can do that quicker you can show
you five minutes off that appointment time things like that and you
(10:44):
know all it did was that just kind of irritated me
because i kind of thought to myself and then the words of that you know
somebody gave me once is you know you know almost
to say well if you feel you can treat that patient more efficiently why
don't you do it then which is kind of a whole putting it
but i totally respect
(11:05):
the fact that you left that environment because i would
never ever once say to
a clinician we promote clinical
freedom yeah so part of that
and one of the biggest things to promote culture is giving
people autonomy okay well if i'm going
to give you autonomy i can't then go and say oh but
(11:26):
by the way can you get that do done in 25 minutes
or whatever it might be because you know you're booking 35 minutes or
you're booking 45 minutes and you know we've got a whole economy to
scale that we've got to deal with here well that's back
to treating people as a number and not treating people as a people as a person
you know i would never shave
timings off my timings because first and
(11:46):
foremost i want to do the best work i can possibly do on every given day i'm
going into and on some days my work will be better than other days that that's
that's part of being a human being but i need a specific amount of time to do
that and if i don't have that time that creates a massive part of stress and anxiety within me.
Because i don't like keeping people waiting it's part of my customer
(12:07):
service whether i was nhs or private i've always been
in that way that's my mindset that's the way i like to treat people
so i don't believe in
in my managing in that way
i believe in having open and honest discussions though so i
believe in someone saying okay let's say for instance
they said well you know you're booking this length of time off but this
(12:29):
is a sort of cost analysis that's happening here so is the
reason why we need that length of time and you have a two-way discussion
about it to come to a situation so then you understand
the perspective of the principal and the principal understands your perspective
and between the two of you you've come to a solution that will then benefit
both of you because it's in the interest of the principal to keep their associates
(12:49):
happy and it's in the interest of the associate to be happy at work and keep
the principal happy so you've got a really good dynamic relationship.
I suppose that's the principle. You want to keep people happy because one of
the biggest growths towards a practice and towards your business is keeping
long-standing associates because that's what patients are essentially coming
(13:09):
back for. They're not coming back for the practice.
They're coming back for that dentist a lot of the time.
That's there, whether that's principal or associate often. I think also the
patients do, they come back for a plethora of reasons,
but certainly, you know, the team, you know, the wider team for sure,
(13:30):
you know, have a huge impact on the patient's experience,
obviously locality and neighbourhoods and all those things.
You know i took over a private practice
from a chap who was retiring and had
been at the practice for 30 years it was a
tough gig and i was expecting that i'm going to probably lose quite a few patients
to begin with well or and so naturally you start make provisions for that and
(13:54):
you you create all these scenarios in your head actually as it happens we probably
lost less than two percent of the patients and all those factors and all those
things that i've that in my head,
none of them materialized because we, you know, we over,
we make things more catastrophic to what they are.
Don't we, you know, in our, in our heads sort of thing. Yeah.
But yeah, no, you're right. People are coming back for the dentist and the way
(14:16):
they're treating and all those things, you know.
So it's very important that then that person is, again, happy and healthy and
engaged at work because you're not going to retain patients if you're not,
especially on a private basis.
No. And, you know, you talked about the autonomy behind it as well.
And that's really important because, again, you know, patients,
(14:39):
if they're coming back for a dentist who work in a particular way, and
I'm going to you know make a fine example of myself here because
I do everything you know
differently you know my composite's all injection molded my
crown preps are different I do a lot of work with ultrasonics actually for cavities
and things like that or the nurse you know and some of the nurses or you know
(15:00):
especially trainees or when I first started you know there are you know nurses
that qualified here for you know over a decade plus and never worked anywhere
else they They're kind of looking at me sort of scratching their heads going,
what the hell is he doing?
But that is kind of the way that I work. And I've invested a lot of money in,
you know, the equipment that I've got.
(15:20):
And, you know, they're kind of seen that I've been here nearly three years,
three and a half years, I suppose.
Sorry, two and a half years, rather. But they've seen that, you know,
there's the reason why I do things, because it does produce good clinical results.
I mean, hopefully touch wood, I've got a fairly low failure rate,
which I pride myself on, but I pride myself on delivering the best standard
(15:42):
of care that I can, because if somebody's going to be working in my mouth or
my parents' mouth or my family member's mouth,
I'm thinking to myself, no, that's what I should be aiming to deliver to everybody else.
I should not be compromising my standards ever, no matter who it is.
You know just because I think well actually you know I don't know them they're just a patient
(16:03):
they're not sort of somebody I know or somebody who's my family everybody sort
of isn't equal and everybody you know is treated you know to
the exact same kind of like clinical standard and I'd put a huge amount
of sort of my emphasis on my clinical standard and probably
to the extent that you know I certainly haven't passed the syndrome but
that's an inherent trait and I'm definitely a perfectionist
as well but that is kind of what produces my
(16:25):
result I've kind
of like lost track i'm not trying i've thought a little bit now but yeah
with the self-employed thing i mean i've said that i buy a lot
of my own equipment you know you find
that you've got associates that do this is this quite a rare thing
that you know associates are investing a lot in
themselves we've got we've got a fantastic associate at our place who is constantly
(16:48):
investing in himself and i love that and by the way i love everything that you've
just said about treating your patients like family the members that's the exact
ethos that that we have in our practice bringing in new techniques.
Helps to keep staff members engaged within
the profession as well it's not just the same oh let's churn
out a do amalgam on the nhf or
(17:09):
whatever it might be the you know staff members
get enthused nurses and and the
auxiliary staff get infused when they're learning new techniques
it's it it's it brightens up their
day so what you're doing is actually in my
opinion a principal's dream it's fantastic i've got
a fantastic associate who invests in himself goes on multiple courses
(17:31):
he buys equipment on certain equipment that he needs he'll come to me and he'll
explain to me why he needs it and i'll say yeah no problems i'll buy that for
you because i can understand why you're going to need it because ultimately
from a business case perspective is you know if If I invest in my associates and keep them happy,
they are a massive asset to me as a business.
(17:51):
Not only just the financial turnover, but also growing the reputation of the
business, the goodwill when it comes for me to sell the business on,
I'm going to benefit from that.
So I would massively encourage all associates out there to do what you've done
and try and better themselves and principals, by the way.
I learned a lot by talking just to my associates and my hygiene therapist,
(18:15):
actually, about certain techniques that they're using.
And again, hygiene therapy is another really important point to touch upon,
a massively, generally underutilized part of our profession,
also self-employed more often than not.
Again, that's even a harder position, I would say, to defend from a self-employed
perspective. So that's also a very, you know.
(18:39):
Interesting point from the hmrc point of view etc we're a massively underutilized
member of the team as well and the amounts that we can all learn from each other is just huge.
So as an associate you know when you talk about.
You know you're one of your associates come to
and say yep you know what happy to get that for you i've been
in corporates where the corporates you know basically put my business argument
(19:01):
across towards it because they're kind of like that's more the hat
that they want and they've kind of gone yep you know what see
your point let's get get it for you and then I've
been in other practices which have kind of gone no you know we
can't you know we can't justify it because
we need everybody using the same to keep it down to economies of
scale that kind of thing so if there's
something in particular that I really want something that I prefer to have how
(19:24):
do I then as an associate kind of you know have that conversation say
look you know what this is what I feel I need
to do my job better or more efficiently you know are
you willing to entertain kind of a conversation and
see where i'm coming from instead of just kind of having the owner's point
of view and kind of like going a bit you know you know because all you're seeing
is the power signs again it's a
(19:46):
tough one and you've almost answered the question yourself in terms of
you've given the business case to why you're doing it and what you're doing
and having you know i talk a lot about
authenticity particularly within leadership okay
you know and and i talk about psychological safety quite
a lot well psychological safety is being able to voice your opinions or carry
(20:06):
out certain things and tasks without fear of reprise and that's ultimately what
we're trying to build in every workplace not just dentistry okay so but you
cannot have psychological safety without having open and honest conversations.
And you can put your business case across and that's all you are in control
of agreed the the principles they're going to put their business case across,
(20:29):
and that's all they're particularly in control of.
Okay? And if at some point those two ideas or ethoses don't meet,
despite the number of honest conversations you're going to have,
then I think it's a question of, well, how valued do you feel as an associate
working for that principle?
And how valued are you as an associate to that principle?
(20:52):
Do you know what I mean? And then there's some bigger conversations to have.
Have or there's a parting of the ways yeah and they're and they're always i
tend to i tend to break things down as much as i can into what are potential outcomes and,
what can possibly happen and once i know all that i can build back up from that
situation you know what i mean but one thing i will always do i will always
(21:17):
have an honest conversation i'll explain my point of view i will listen to your point of view,
And if we, more often than not, in virtually 99% of cases, we'll come to compromises.
And that's what's after. Most people in most workplaces just want to be heard.
They want to be heard and they want to be understood.
(21:38):
And they also want to understand decision-making processes that occur,
as opposed to just, I want this, nah, computer says no.
Yeah. I think sort of being heard and sort of being understood are sort of important
things. And I mean, you know, for both associates and all team members,
I think it's important to actually understand, you know, the side from the business
(21:58):
in terms of why you would or you wouldn't do something.
And I think that's no matter what it is, whether it's new equipment or,
you know, a new system that's implemented or, you know, HMRC,
you know, infection control policy, whatever.
Because then if you understand, you know, you're actually just more likely to
do it rather than kind of, you know, being barked at.
(22:20):
I think, I suppose, one of the last things I think I probably want to mention
then, because we've covered kind of, you know, how autonomy is important,
letting associates kind of develop and kind of just be themselves within the practice.
But from an associate's point of view, I think you have to be,
you know, not just a leader, because you kind of have to still be a leader in
(22:40):
terms of bringing sort of other people in the team along with you in terms of
how you do things, why you want to do things.
And, you know, the day-to-day kind of like, you know, ways that people work,
because you still have a small team around you, even though you're,
you know, you're not actually the actual business owner itself.
But then at the same time, because you're not the, you know,
(23:03):
the owner of the practice, you're still a follower.
So you're kind of wearing two hats and, you know, you're,
How do you balance those things? Is there a good middle ground?
Is it just dependent on the day-to-day dynamics?
Because obviously that's going to change each time. Is it dependent on practice?
And I don't even know if I'm making sense with this point. I feel like I am.
(23:25):
I think you get me because you're nodding your head.
I sort of get you, 100%, because obviously, as a principle, we have that exact same dynamic.
Last, everyone thinks that the principle is completely in control.
And yes, I can understand why that's the case.
But actually, if you think about what the principal also has to deal with,
(23:47):
you know, the stress of running the business, the stress of compliance,
the stress of keeping team members happy and the dynamics of all that,
the financial aspects of it all, managing the entire practice,
not just managing, you know, your own business as well as you as Hussein Dental.
You know what I mean? so a lot of
people in dentistry and this is a good thing and
(24:09):
a bad thing i think a lot of people in dentistry wear a lot of hats and
and therefore it's constantly juggling balls
spinning plates whatever it is that we might
call it and it's very difficult i think i think
i've already touched on a few things i think having open honest
and respectful conversations is massively important okay because
(24:29):
again wearing the same hats and
being able to to voice your opinion but
also being able to respect other people's opinion and listen
and actively listen is massively important
to see other people's perspective and having a growth mindset essentially okay
i think that's really important i think looking after yourself as an associate
knowing the stress and the stressful environment the dentistry is and what you've
(24:54):
just outlined there as well is very stressful You have a responsibility to yourself
to make sure you are healthy,
you know. So looking after yourself.
Practicing techniques and self-care techniques that are going to allow you to
stay mentally healthy and more productive at work.
Okay. For the benefit of you and for the benefits of the practice,
(25:14):
you know, embracing and acknowledging stress and, and, and accepting that stress
is a part of people's lives.
And actually stress is massively important to us all. It's important for us
to have stress because that builds, that helps us build from it.
It helps us build resilience it helps us to overcome challenges
in the future so having stress is good having too
(25:37):
much stress which then becomes a feeling of overwhelm and
becomes too overwhelming is when it starts to become mentally unhealthy and
recognizing that i like using the word pressure and then
if there's too much pressure it's pressure then becomes stress so
i'm happy to have pressure because pressure once drives you but
i think when it becomes stress that's when it's just gone too far
in the wrong direction and that's when you know the pressures kind
(25:59):
of overwhelmed you and i think oh that's a good description of
it yeah listen whichever whichever description resonates
in your mind you know the world health organization talk about
stressors as the thing within their definition of mental health it you know
there's no right or wrong whatever resonates with you if you want to call it
pressures stress whatever it might be that's going to resonate the note the
(26:22):
court part is though is recognizing when those pressures or or that stress,
or those stressors are becoming too much.
And then you have to then look at things and reevaluate and try to then manage that situation.
You know, you mentioned before things like imposter syndrome,
dentistry, massive with imposter syndrome.
(26:44):
We're very isolated. Although you're an associate in a practice,
you are isolated in your surgery.
By the same token, when I practice, I'm isolated in my surgery.
So it's an isolated perfectionism you mentioned before huge
huge problem in dentistry we agonized over the
one percent that you know you might have an air blow in your composite you
won't talk about the beautiful shading that you've done and the way you've got
(27:06):
it polished and all happens you talk about this one air blow that just sticks
in your mind managing things like that are massively massively important within
our profession you know yeah and we're quite fortunate that as part of thought
you know what there's 12 of us of the dentists,
I think it's at least 12 anyway, it keeps growing.
You know, we have regular peer reviews and we do tend to kind of at least talk
(27:29):
and we've got WhatsApp chats and we're fortunate that everybody within our practice
seems to have different special interests. We've got lots of people that we can lean on.
And I think that sort of does make for a good sort of practice dynamic,
knowing that there is a lot of support out there.
And support is a big thing because clinical clinical support is,
you know, necessary in kind of today's modern kind of practising environment.
(27:53):
And you do need people that you can lean on,
But if you're kind of within a smaller practice, you know, can you kind of still
kind of get that in a smaller practice compared to such a large practice where
you've got more people around you?
Well, we're a very small practice and we're one surgery. So whenever I work,
(28:13):
I'm by myself. Whenever my associate works, they're by themselves.
As a one surgery practice, it's difficult having and not just clinical support.
You mentioned support there, but having support in general is
massively important so the biggest and the
biggest most influential thing that i have ran in
my dental practice is definitely utilizing the
(28:35):
platform from synergy mental health to understand our
workplace culture and have people comment on
what's happening within our business completely from
an entire collective perspective perspective and then
was all coming together to help us
improve the environment that's what we do
(28:55):
and that is probably been the biggest most
influential thing in my business that i've had after practicing
dentistry for two decades to be honest with you because it's brought
together a real sense of togetherness and we've
had some very challenging conversations but through
challenging conversations and working through them actually strengthens
team dynamics and team and team team
(29:17):
bonding so that's that's a
massively massively important thing and i think that you know
people should be business owners should
be doing this at all times for sure no some
great tips there rick thanks very much because yeah it's you
know it's hard being an associate and i completely say it's
hard being a practice owner and i think you know yeah it's.
(29:38):
Important that the two do meet in the middle and everybody sort
of gets on because if you don't the only person actually
suffering and fit is the patients and we're
all here for patients and that's also my room we
are and just on that note though if we don't
meet in the middle and people don't meet people actually the
people within the team and you and me we all
(30:00):
suffer and the patients as well but we all suffer and
so it's massively massively important to build
those team dynamics for sure yeah i think that's a
good final point in terms of the sort of associate dynamics i
I guess hopefully we'll be able to cover sort of the wider team dynamics later
on at some point another time so yeah thanks very much Rick for yeah taking
(30:21):
the time to join us and talking us all through some of what we need to help
our associates but also what associates can do to kind of you know help out
sort of practice owners and practice managers thanks very much again.
Music.
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